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Pregnancy and Hypothyroidism

Hypothyroidism is associated with menstrual irregularities and infertility. Hypothyroidism during pregnancy is almost always mild and almost always due to Hashimoto’s thyroiditis. It is very important to make the diagnosis early, as hypothyroidism has been associated with maternal and fetal morbidity.

Diagnosis of hypothyroidism is confirmed by an elevated TSH level. All the cases of pregnancy should be screened for hypothyroidism if they have a history of thyroid disease, goiter, other autoimmune disease, recurrent miscarriage, or family history of autoimmune thyroid. 

During pregnancy, the thyroid hormone requirements in the majority of patients may increase up to 50%. The presence of antithyroid antibodies in the absence of thyroid dysfunction is associated with an increased risk for miscarriage.

Pregnancy and Hyperthyroidism

Many signs and symptoms of hyperthyroidism occur in normal pregnancy. Specific signs of hyperthyroidism are failure of the mother or fetus to gain weight, resting tachycardia, an enlarged thyroid gland, exophthalmos, lid lag, muscle weakness, diarrhea, or tremor.

The most common cause is Graves’ disease, which often has clinical exacerbations during the first trimester of pregnancy. Toxic multinodular goitre (MNG) is anuncommon cause. It usually occurs in women older than 40 yr with a history of MNG.

The diagnosis of hyperthyroidism during pregnancy is made by suppressed TSH with an elevated free T4 or free T3. Measurement of TPOAb can confirm the autoimmune nature of the thyroid dysfunction if other signs associated with Graves’ disease are not present. TSI is measured during the third trimester, because high titers increase the risk of fetal goiter and hyperthyroidism due to TSI transfer across the placenta. If the TSI is high, a third trimester fetal ultrasound should be considered to determine if the fetal goiter will prevent a vaginal delivery.

Hyperemesis gravidarum is associated with a low TSH without elevated thyroid hormone levels.


·        Chopra IJ. Clinical review 86: euthyroid sick syndrome: is it a misnomer? J Clin Endocrinol Metab 1997; 82:329–334.

·        Cooper DS, Halpern R, Wood LC, Levin AA, Ridgway EC. L-Thyroxine therapy in subclinical hypothyroidism. A double-blind, placebo-controlled trial. Ann Intern Med 1984; 101:18–24.

·        Nystrom E, Caidahl K, Fager G, Wikkelso C, Lundberg PA, Lindstedt G. A double-blind cross-over 12-month study of L-thyroxine treatment of women with ‘subclinical’ hypothyroidism. Clin Endocrinol (Oxf) 1988; 29:63–75.

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Dr. Rajneesh Sharma
There are some Points to Remember in pregnancy & thyroid dysfunction
• Pregnancy causes normal changes in thyroid function but can also lead to thyroid disease.
• If uncontrolled during pregnancy, hyperthyroidism—too much thyroid hormone in the blood—can be dangerous to the mother and cause health problems such as congestive heart failure and poor weight gain in the baby.
• Mild hyperthyroidism in pregnancy does not require treatment. More severe hyperthyroidism is usually treated with drugs that interfere with thyroid hormone production.
• If uncontrolled during pregnancy, hypothyroidism—too little thyroid hormone in the blood—also threatens the mother’s health and can lead to developmental disabilities in the baby.
• Hypothyroidism in pregnancy is safely and easily treated with synthetic thyroid hormone.
Postpartum thyroiditis—inflammation of the thyroid gland—causes a brief period of hyperthyroidism, often followed by hypothyroidism that usually resolves within a year. Sometimes the hypothyroidism is permanent
I agree with your point Dr. Sarswat. Hypothyroidism in pregnancy is safely and easily treated with synthetic thyroid hormone.
Yes Sir, I have a case where the hypothyroidism persists ever since pregnancy. The TPO antibodies in this case in very high, i.e. 3500 (normal limit- 50)
That may or may not resolve after delivery. Must be treated with partially similar remedy.
Now my question is - Homoeopathy treats all diseases where perfact disease picture is found, either partially similar or the similimum. Whenever, in diseases with unknown causes, the Homoeopathic treatment is assorted, cure settles and the cause is removed due to activation/ stimulation of immune system as well as healing system of the living body. Whenever, the exciting cause of the disease is found, that should be removed or prevented mechanically or by any other possible mean. This exciting cause may behave as maintaining cause too. During pregnancy, fetus is the cause. Then what should happen if we treat a case of Pregnancy induced ailment with so called similimum remedies as per norms of Homoeopathy?
I think we should not treat the pregnants in absolutely Homoeopathic way. We can use partially similar and shallow acting remedies only to palliate the sufferings and wait till the delivery of the infant is not done.
@ Dr.Rajneesh, please clarify ---- if we don't treat a pregnant lady with similimum then how will the treatment of the fetus during intra-uterine period be accomplished? We say that the fetus similimum during this period is same as the mother.
We should try partially similar drugs.
I didn't get Sir, what will be partially similar drugs?
Dear Dr. Basu, when we repertorize a case, the first remedy is mathematically similimum. After deciding with materia medica, we confirm this by some small or some general/common symptoms. In case of partially similar remedy, we should consider the particulars only. The similimum particular with some different generals is the partially similar remedy for palliation.
Thank you Dr.Rajneesh, but during intra-uterine life we treat the fetus with the mother's constitutional medicine, so that it shall have a healthy constitution as refered by Dr. Hahnemann. Then how will partially similar remedy help here?
The fetus, in intrauterine life, is not a complete individual one. It is partial individual and therefore only partially similar remedy will be its similimum.
Ok. Thanks Dr.Rajneesh.


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